Table 2

Paediatric respiratory medicine syllabus 2019

Module 1. Structure and function of the respiratory system (mandatory)

  • 1 Anatomy and development

  • 2 Applied respiratory physiology and pathophysiology (including common respiratory symptoms)

  • 3 Immunology and defence mechanisms

  • 4 Environmental determinants of childhood respiratory health and disease

Module 2. Evaluation of respiratory symptoms and signs (mandatory)
Evaluation and management of:

  • 1 Acute and chronic cough

  • 2 Stridor, wheezing and other respiratory noises

  • 3 Dyspnoea and breathlessness

  • 4 Respiratory distress and respiratory insufficiency

  • 5 Questionnaires in clinical assessment

Module 3. Pulmonary function and diagnostic testing (mandatory)
Measurement, performance and interpretation of:

  • 1 Volume–time and flow–volume curves

  • 2 Static lung volumes

  • 3 Respiratory mechanics

  • 4 Reversibility testing

  • 5 Bronchial provocation testing

  • 6 Cardiopulmonary exercise testing

  • 7 Blood gases and oximetry

  • 8 Lung diffusion

  • 9 Ventilation homogeneity

  • 10 Respiratory muscle function

  • 11 Equipment maintenance, hygiene and infection control during test procedures

  • 12 Definitions of measured indices

  • 13 Choice and appropriate use of reference values

  • 14 Test variability and reproducibility

  • 15 Quality control in paediatric lung function laboratories

  • 16 Health and safety issues in relation to paediatric lung function testing

  • 17 Lung function in non-cooperative children

Additional diagnostic tests
 Measurement, performance and interpretation of:

  • 1 Exhaled nitric oxide measurements

  • 2 Induced sputum testing

  • 3 Assessing respiratory risk of air travel, altitude and diving

Module 4. Airway endoscopy (mandatory)

  • 1 Organisation of an endoscopy suite including equipment maintenance and hygiene

  • 2 Indications for, contraindications, performance and interpretation of flexible bronchoscopy and associated procedures

  • 3 Sedation and anaesthesia for paediatric flexible bronchoscopy

  • 4 Indications for and contraindications of interventional bronchoscopy techniques other than foreign body removal

  • 5 Indications for and contraindications of rigid bronchoscopy

  • 6 Evaluation and management of risks and complications of airway endoscopy

Module 5. Imaging (mandatory)

  • 1 Indications for, interpretation and basic principles of conventional radiography, computed tomography, magnetic resonance imaging, ultrasonography and isotope imaging methods

  • 2 Comparative radiation burden of the different procedures

  • 3 Indications for interventional radiology

Module 6. Respiratory infections (mandatory)
Epidemiology, diagnosis, management and complications of:

  • 1 Acute upper respiratory tract infections

  • 2 Acute lower respiratory tract infections

  • 3 Pleural infections

  • 4 Tuberculosis (TB) and non-TB mycobacterial diseases

  • 5 Diagnosis and management of respiratory infections in high-risk situations

  • 6 Diagnosis and management of protracted bacterial bronchitis and non-CF bronchiectasis

  • 7 Lung involvement in the immunocompromised host

  • 8 Microbiology and infectivity

  • 9 Pharmacology of antimicrobial and antiviral drugs

  • 10 Immunisations for respiratory pathogens

  • 11 Accuracy and interpretation of microbiological tests

Module 7. Asthma and wheezing disorders (mandatory)

  • 1 Different phenotypes and their different pathologies and long-term outcomes (including underlying pathophysiology and basic epidemiology)

  • 2 Environmental factors relevant to asthma and other wheezing disorders

  • 3 Difficulties in diagnosis and differential diagnosis

  • 4 Management of asthma at different ages including age-related pharmacology, and pharmacological and non-pharmacological management

  • 5 Management of difficult and severe asthma

Module 8. Allergic disorders (mandatory)
Epidemiology, diagnosis and management of:

  • 1 Anaphylaxis

  • 2 Allergic rhinitis

  • 3 Bronchopulmonary aspergillosis

  • 4 In vivo and in vitro testing for allergic disorders

  • 5 Prevention measures

  • 6 Diagnosis and basic management of associated allergic conditions

Module 9. Cystic fibrosis (CF) (mandatory)

  • 1 Epidemiology, genetics, pathophysiology and prognosis

  • 2 Screening and diagnosis

Epidemiology, diagnosis, management and complications of:

  • 3 CF lung disease

  • 4 Extrapulmonary manifestations of CF including nutrition

  • 5 Microbiology relevant to CF, including cross-infection

Module 10. Congenital malformations (mandatory)

  • 1 Epidemiology, diagnosis and management of congenital malformations affecting the respiratory system

  • 2 Antenatal diagnosis and management

  • 3 Follow-up and long-term outcomes

Module 11. Bronchopulmonary dysplasia/chronic neonatal lung disease (mandatory)

  • 1 Epidemiology, aetiology, prevention, diagnosis, management and complications

  • 2 Follow-up and long-term outcomes

Module 12. ENT (ear, nose and throat) and aerodigestive-related respiratory problems (mandatory)

  • 1 Aspiration due to disorders of feeding and swallowing

  • 2 Gastro-oesophageal reflux

  • 3 Laryngeal and tracheal disorders

  • 4 Foreign body inhalation

Module 13. Respiratory presentation or complications of systemic/extrapulmonary conditions (mandatory)

  • 1 Primary immunodeficiency syndromes

  • 2 Secondary immunodeficiency syndromes/immunosuppression

  • 3 Cardiac disease

  • 4 Gastrointestinal, liver and kidney disease

  • 5 Haematological disease

  • 6 Obesity

  • 7 Connective tissue diseases

  • 8 Musculo-skeletal and neuromuscular diseases

Module 14. Rare diseases (mandatory)
Pathophysiology, genetics, aetiology, diagnosis and management of:

  • 1 Primary ciliary dyskinesia

  • 2 Bronchiolitis obliterans

  • 3 Interstitial lung diseases

  • 4 Pulmonary vascular disorders including pulmonary arterial hypertension

  • 5 Pulmonary haemorrhage

  • 6 Pleural diseases including spontaneous pneumothorax

  • 7 Drug- and radiation-induced lung diseases

  • 8 Other rare lung diseases

Module 15. Respiratory sleep medicine and breathing control 
disorders (mandatory)

  • 1 Physiology and pathophysiology of sleep relevant for paediatric respiratory medicine

  • 2 Indications and interpretation of the results of polysomnography

Epidemiology, aetiology, diagnosis of, screening for, and complications of:

  • 3 Obstructive sleep apnoea syndromes

  • 4 Central sleep apnoea/hypoventilation

  • 5 Dysfunctional breathing/hyperventilation syndromes

Module 16. Long-term management of chronic respiratory disorders (mandatory)

  • 1 The multidisciplinary team

  • 2 Health education (preventive medicine)

  • 3 Patient education and self-management

  • 4 Nutritional management

  • 5 Psychological support for children and families

  • 6 Principles of physiotherapy techniques, indications and limitations

  • 7 Sport and exercise therapy

  • 8 Management of end-stage lung disease including palliative care

  • 9 Indications for lung transplantation and non-surgical care of the lung transplant patient

  • 10 Assessment of quality of life

Module 17. Inhalation therapy (mandatory)

  • 1 Basic science of aerosol production and delivery

  • 2 Indications for inhalation therapy

  • 3 Available techniques and their advantages and limitations

  • 4 Delivery of drugs in children with artificial airways

Module 18. Technology-dependent children (mandatory)
Management, monitoring and weaning of:

  • 1 Home oxygen therapy

  • 2 Invasive and noninvasive home ventilatory support

  • 3 Tracheostomy

  • 4 Basic technical understanding of equipment

  • 5 Airway clearance techniques

  • 6 Recognition of associated problems (including neurodevelopmental assessment)

Module 19. Epidemiology and environmental health (mandatory)

  • 1 Basic understanding of epidemiological principles

  • 2 Impact of indoor and outdoor air pollution on respiratory health

  • 3 Smoking impact, prevention and cessation

  • 4 The burden of paediatric respiratory diseases on healthcare resources

Module 20. Evidence-based medicine (mandatory)

  • 1 Scientific literature appraisal

  • 2 Understanding and application of the ethical principles of paediatric research

Module 21. Research (optional)

  • 1 Basic understanding and application of the principles of planning, designing, conducting, analysing and publishing research projects